Bill of Health

JUNE 15, 2023

Merck alleges that the price negotiation program operates as a price control because it effectively requires manufacturers to accept the maximum fair price as a condition of participation in Medicare and Medicaid. Covered entities include various federally funded clinics and hospitals that serve low-income patients.

Medicare 195

Medicare Medicare Medicaid Medicaid 195

HIT Consultant

OCTOBER 22, 2024

Making HPH-CPGs a Condition of Participation (CoP) for CMS : The Centers for Medicare & Medicaid Services (CMS) could require adherence to HPH-CPGs as a condition for participating in Medicare and Medicaid programs. About Ty Greenhalgh Ty Greenhalgh is Industry Principal of Healthcare at Claroty.

HIPAA 139

HIPAA Compliance Public Health Medicaid 139

AIHC

APRIL 22, 2025

Atkins, PhD, MSW, LMSW, CPC, CIGE The governments new whistleblower complaint portal launched in April 2025 emphasizes the importance of complying with regulations related to qui tam suits, OCR investigations and protecting the rights of employees submitting a tip or complaint internally or to authorities. Written by Dr. Stacey R.

Compliance 89

Compliance HIPAA Compliance Officers Fraud 89

Healthcare It News

JANUARY 4, 2022

"As a result of reaching a tipping point on these issues, I believe 2022 will see the beginning of a Peace Corps-type effort to address burnout through a combination of industry innovation and government incentives," he said.

COVID-19 362

COVID-19 Hospitals Nurses Medicaid 362

Compliancy Group

JANUARY 23, 2025

The federal False Claims Act prohibits someone from knowingly presenting or causing a false claim for payment if the federal government will pay for that claim. These settlements involved managed care providers, physicians, hospitals, pharmacies, pharmaceutical companies, laboratories, and other medical facilities. While the $1.67

Fraud 98

Fraud Medicare Medicare Regulatory Compliance 98

Healthcare It News

APRIL 29, 2024

Salesforce for public health and other government agencies could integrate natural language processing to ease administrative burdens and generate richer case files. With the new platform, government users would also be able to leverage Appointment Assistant, Slack and Visual Remote Assistant.

Public Health 300

Public Health Governance Medicaid Medicaid 300

HIPAA Journal

NOVEMBER 17, 2022

Caroline Cook, Privacy Consultant, GDH Government Consulting Services, has shared her thoughts. As a teenager, I volunteered in hospitals and nursing homes. That led to my serving as the Privacy Officer for the hospital beginning with the implementation of the Privacy Rule. I’ve worked in healthcare for over 30 years.

Governance 105

Governance HIPAA Compliance Nursing Homes 105

HIPAA Journal

NOVEMBER 21, 2022

million being defrauded from Medicaid, Medicare, and private health insurance programs. The payments were intended for hospitals for providing covered medical services. The arrests were related to a series of scams that spoofed hospital email accounts. million, and $6.4 million, and $6.4

Medicaid 101

Medicaid Medicaid Medicare Medicare 101

Bill of Health

MARCH 15, 2022

During the early months of the pandemic, disabled people became unemployed at disproportionate rates , likely related to substantial employment declines in certain industries, such as retail and hospitality, where disabled people are overrepresented. In July 2021, the U.S.

COVID-19 246

COVID-19 ADA Medicaid Medicaid 246

Healthcare It News

JANUARY 18, 2022

Social determinants of health are major contributors to health inequity and rising healthcare costs in vulnerable populations such as Medicaid beneficiaries. That said, hospital social workers and nurse discharge planners are accustomed to having to help patients with these types of issues during an inpatient admission.

COVID-19 363

COVID-19 Medicaid Medicaid Patient Satisfaction 363

HIPAA Journal

MARCH 28, 2025

The account was reviewed, and on January 24, 2025, it was confirmed that emails in the account contained the protected health information of patients of Beacon Health Systems Three Rivers Health Hospital in Michigan. This incident occurred at the business associate Restorix, which provides hospitals with wound care services.

Licensing 70

Licensing Health Insurance HIPAA Medicaid 70

Healthcare IT Today

JANUARY 23, 2025

The HEI Reward Factor will assess how well plans serve beneficiaries with social risk factors such as low income, disability, or dual eligibility for Medicaid. The new HEI is part of a broader effort by the federal government to use payment as a mechanism to spur action on closing health equity gaps.

Medicare 92

Medicare Medicare Medicaid Medicaid 92

Healthcare IT Today

JANUARY 20, 2025

My career spans over three decades in health information technology, health policy and public health, including roles at the Centers for Medicare and Medicaid Innovation and in state government. What are some of the government initiatives and reimbursements that support this approach?

Governance 67

Governance Medicaid Medicaid Health Outcomes 67

Healthcare IT Today

SEPTEMBER 19, 2024

The following is a guest article by Aaron Timm, EVP and Chief Commercial Officer at Vivalink In recent years, Hospital-at-Home (HaH) programs have been accepted more widely as a way of providing acute-level care to patients at home. with its introduction of the Acute Hospital Care at Home (AHCAH) waiver in 2020.

Hospitals 96

Hospitals Governance Telemedicine Payment Systems 96

AIHC

DECEMBER 27, 2024

Here, the court affirmed that hospitalization does not negate a persons right to bodily privacy when it noted that, It would be a strange doctrine that would decree that the sanctity of the right of privacyfully respected in a public restroom, is forfeited by the fact of falling ill and becoming hospitalized. 8] In Backus v.

Informed Consent 98

Informed Consent Bioethics ADA Medical Personnel 98

Healthcare It News

JULY 11, 2024

Department of Health and Human Services has already required Fast Healthcare Interoperability Resources APIs in all certified electronic health record systems across the provider ecosystem, which currently covers 97% of hospitals and more than 80% of ambulatory provider organizations, Tripathi noted.

US Department of Health and Human Services 288

US Department of Health and Human Services Public Health COVID-19 Governance 288

Healthcare IT News - Telehealth

JUNE 30, 2020

Signers pointed out that the authorities granted to the Department of Health and Human Services and the Centers for Medicare and Medicaid Services are restricted to the public health emergency period triggered by COVID-19. Senate HELP Committee Chair Sen. Lamar Alexander, R-Tenn., Meanwhile, U.S. Butterfield, D-N.C., and Glenn Thompson, R-Pa.,

US Department of Health and Human Services 205

US Department of Health and Human Services COVID-19 Telemedicine Medicare 205

Healthcare IT News - Telehealth

AUGUST 5, 2020

In March, the Centers for Medicare and Medicaid Services released new guidance regarding remote patient monitoring. The change was just one of a number of government initiatives enacted to support RPM, explained Tyler Fletcher, global head of medical, advertising and Americas consulting at GlobalData, during a HIMSS20 Digital session.

COVID-19 211

COVID-19 Medicaid Medicaid Public Health 211

HIT Consultant

JANUARY 27, 2025

Capacity Planning: AI tools help hospitals predict admission surges, ensuring adequate staffing and resources during peak demand periods. These improvements span internal and customer-facing operations at payers, care delivery organizations, and government entities such as the Centers for Medicare & Medicaid Services and public hospitals.

Patient Satisfaction 99

Patient Satisfaction COVID-19 Medicaid Medicaid 99

Healthcare IT News - Telehealth

OCTOBER 27, 2020

The government has signaled its support for reimbursing some telehealth services, at least in the short term. "The government can play a very positive role in telehealth by establishing clear standards and clear reimbursement guidelines," said Selesnick.

COVID-19 202

COVID-19 Governance Medicare Medicare 202

Healthcare IT Today

NOVEMBER 5, 2024

Karen Iapoce, Vice President, Government Programs at ZeOmega Social determinants of health, such as socioeconomic status, education, and access to healthcare, have a profound effect on population health outcomes and contribute to health disparities. The following are quotes from our brilliant Healthcare IT Today Community on this topic.

Health Outcomes 89

Health Outcomes US Department of Health and Human Services Federal Policy Governance 89

Healthcare IT News - Telehealth

NOVEMBER 8, 2021

National Nurses United and the California Nurses Association released a joint statement this past week criticizing Kaiser Permanente's aims to expand advanced hospital services into patients' homes. "The Advanced Care at Home Program does not limit the role of nurses in hospitals." WHY IT MATTERS.

Nurses 192

Nurses COVID-19 Patient Satisfaction Hospitals 192

Healthcare IT News - Telehealth

OCTOBER 2, 2020

Department of Health and Human Services to issue guidance to states about how to increase access to telehealth under Medicaid and the Children’s Health Insurance Program. Examples of states that have used waivers under the Medicaid program to test expanded access to telehealth. WHY IT MATTERS. healthcare system."

US Department of Health and Human Services 167

US Department of Health and Human Services COVID-19 Medicaid Medicaid 167

Fierce Healthcare

JANUARY 18, 2024

The Senate voted 77-18 to pass a bill Thursday that would punt a partial government shutdown, set to go into effect this weekend, back to early March. |

Medicaid 110

Medicaid Medicaid Governance Hospitals 110

Healthcare IT Today

DECEMBER 22, 2024

Partnerships Identity security vendor SailPoint acquired Imprivatas identity governance and administration business , and the two companies will become go-to-market partners. DUOS updated its digital health platform for seniors to enable end-to-end applications for federal and state assistance programs such as SNAP and Medicaid.

Medicare 84

Medicare Medicare FDA Telemedicine 84

Healthcare IT News - Telehealth

JULY 16, 2020

Now, the question becomes : How many of those changes, particularly regarding temporary waivers issued by the Centers for Medicare and Medicaid Services, will become permanent? "Currently there's parity between in-person and telehealth visits," Leary pointed out. "We anticipate a lot of discussion around that."

COVID-19 178

COVID-19 Medicare Medicare Governance 178

Healthcare IT News - Telehealth

NOVEMBER 2, 2020

Located in the heart of North Philadelphia, Temple University Hospital serves one of the nation’s most economically challenged and diverse urban populations. More than 85% of the patients served by Temple are covered by government programs, including Medicare and Medicaid. ” USING FCC AWARD FUNDS.

Telemedicine 176

Telemedicine COVID-19 Nurses Medicare 176

YouCompli

FEBRUARY 4, 2025

Quality of Care and Quality of Life For decades, the OIG and other government enforcement agencies have emphasized the importance of the quality of care and quality of life for nursing facility residents. Lets review some of the highlights. The OIG expects nursing facilities to be proactive in their oversight of billing compliance.

Nurses 52

Nurses Overpayments Overpayment Compliance 52

Hall Render

MARCH 12, 2025

Background of the Case Relator Rosales filed a qui tam action in June 2020 against a hospice care provider and its subsidiaries, alleging fraudulent conduct aimed at securing payments from Medicare and Medicaid. The central issue before the Fourth Circuit was whether this dismissal was warranted.

Fraud 52

Fraud Governance Medicaid Medicaid 52

MedTrainer

JANUARY 30, 2024

What types of healthcare facilities are required by the government to have a compliance program? In this blog, we’ll outline what types of healthcare facilities are required by the government to have a compliance program and why compliance is crucial for both healthcare organizations and the agencies that support them.

Governance 52

Governance Compliance Nursing Homes Medicaid 52

Healthcare It News

FEBRUARY 28, 2023

UPMC Central Pennsylvania, a hospital that in 2021 achieved Stage 7, the top of the HIMSS Electronic Medical Record Adoption Model, has been a leader in telemedicine, with more than two dozen robust virtual care programs. The majority of patients using the virtual-first clinic are females (70%), and the average age range has been 40-50.

Electronic Medical Records 305

Electronic Medical Records Telemedicine COVID-19 Health Insurance 305

HIPAA Journal

DECEMBER 22, 2022

trillion omnibus appropriations bill has been released by the House and Senate Appropriations Committees which, if passed, will ensure that the government remains funded until September 30, 2023. The bill must be signed by the president on Friday this week, when government funding is set to expire. The text of a $1.7

FDA 115

FDA COVID-19 Governance Medicaid 115

MedTrainer

NOVEMBER 14, 2023

While federal operations are slowed, reduced, or put on pause during a government shutdown, healthcare services must continue to operate. What Is a Government Shutdown? Without budget authorization from Congress, a variety of government services and operations come to a halt. But what does this mean for your healthcare business?

Governance 52

Governance Medicaid Medicaid Medicare 52

Verisys

MARCH 6, 2025

All parties must adhere to both federal and state laws, including those set by governing bodies, and follow ethical standards that safeguard the well-being of patients. The primary governing bodies that set healthcare compliance standards include: The U.S.

Compliance 52

Compliance HIPAA Licensing Governance 52

Health Populi

JUNE 3, 2020

McKinsey’s report models outpatient and office visits that can be virtually enabled for patients covered by both commercial and public sector health plans (Medicare and Medicaid). ” Those estimates include, 20% of diverted emergency department visits. 24% of all office visits and outpatient encounters, plus.

COVID-19 153

COVID-19 Hospitals Medicaid Medicaid 153

Medisys Compliance

MARCH 31, 2023

Ohio Medicaid is a government-sponsored healthcare program that provides medical benefits to eligible individuals in Ohio. To become a provider for Ohio Medicaid, you must first enroll in the Ohio Medicaid program. Here are the steps of provider enrollment for Ohio Medicaid: Provider Enrollment for Ohio Medicaid 1.

Medicaid 52

Medicaid Medicaid Licensing Medical Billing Outsourcing 52

Verisys

APRIL 3, 2025

As a centralized hub of critical practitioner data, the NPDB serves as a powerful ally in provider credentialing , helping hospitals, medical boards, and institutions verify backgrounds, track malpractice claims, and ensure regulatory compliance. Enter the National Practitioner Data Bank (NPDB), a vital tool in this effort. Lets explore.

Malpractice 52

Malpractice Licensing Compliance Hospitals 52